First boy receives permanent artificial heart

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Medical success: boy receives permanent, artificial heart. A background report.

The news that Roman doctors successfully inserted a permanent, artificial heart into a 15-year-old boy (15) in a ten-hour operation caused a sensation worldwide. For the first time, an adolescent was implanted with an artificial heart, which is not only used to bridge a pending heart transplant.

Artificial heart for the first time in a young person under the age of 16 The boy was unable to get on a waiting list for a donor organ because of a muscular disorder, so the doctors at the children's hospital "Ospedale Pediatrico Bambino Gesu" decided on the solution with a permanent artificial heart. As part of a ten-hour operation, the medical team led by Antonio Amedeo used an artificial heart for the boy, which is said to remain permanently in his chest. "It is the first time worldwide that a child under the age of 16 has such a heart," Antonio Amedeo told dpa.

Artificial hearts as support systems for the heart Until now, permanent artificial hearts have only been used by adults. There are different variants that can serve both to support and to replace the natural heart. While the term artificial heart gives the impression that diseased hearts are completely replaced, in reality this is usually not the case. As a rule, artificial hearts only serve to support the natural heart, whereby they usually only refer to one of the two ventricles. These support systems (ventricular assist device - VAD) work similarly to a hydraulic pump and help to relieve the heart in cardiac muscle weakness or to maintain the circulation. Depending on the ventricle to be relieved, a distinction is made between left heart support systems (LVAD), right heart support systems (RVAD) and, if both heart chambers are supported, biventricular support systems (BiVAD).

Artificial heart completely housed in the chest The 15-year-old boy was implanted in the left heart chamber in the children's hospital "Ospedale Pediatrico Bambino Gesu", which belongs to the Vatican and is one of the most renowned children's hospitals in Italy. As part of the ten-hour operation, the medical team led by Antonio Amedeo cut the patient's sternum (sternum) lengthways (median sternotomy) in order to then insert the artificial heart, implant the inflow cannula into the tip of the left ventricle and the outflow cannula to connect the ascending aorta. To reduce the risk of infection, the doctors inserted the artificial heart completely into the chest.

Mini artificial heart weighs only 92 grams Only last year Heidelberg physicians were able to completely accommodate a mini artificial heart weighing only 92 grams for the first time in the patient's chest, which significantly reduced the risk of infection. In the past, these sometimes weighed more than a kilogram and could not be accommodated in the chest due to lack of space. The 92 gram mini artificial heart is the fifth generation of the so-called DeBakey heart, which was developed in the 90s by the heart specialist Michael DeBakey in collaboration with the US space agency Nasa. It is able to completely replace the function of the left ventricle and allows the patient to live a relatively normal life due to the complete placement in the body.

Power supply as an infection risk Only the power supply has to be done externally with this model as well, but this still leaves one of the biggest problems when inserting artificial hearts: the risk of infection due to the necessary external power supply. The Italian doctors have also come up with something special here. The artificial heart is powered by a plug behind the left ear and a battery connected to it, which the boy carries on his belt, explained Antonio Amedeo. However, an infection via the external power source cannot be ruled out here either.

Doctors have so far been reluctant to comment on the success of the operation. Although the Italian media already admire "The Heart Wonder of Rome", the doctors have so far been reluctant to assess the success of the operation. It is not clear how the boy's already sick organism will work with the new artificial heart. However, if everything else goes well, the boy could live with the battery heart for 20 to 25 years instead of a few months, emphasized Antonio Amedeo. Artificial hearts have been used in adults for up to almost 15 years as a “bridge” before a heart transplant. (fp, sb, 05.10.2010)

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First child receives permanent artificial heart

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